A report today published in Journal of the American Heart Association shows elevated cancer rates in patients with Takotsubo Syndrome (or ‘broken heart syndrome’). I found the article to be timely as I have had some clinical experience with TTS.

 

Takotsubo syndrome is a weakening of the left ventricle, the heart’s main pumping chamber, usually as the result of severe emotional or physical stress, hence the term ‘broken heart syndrome.’ Stressors range from sudden illness, the loss of a loved one, a serious accident, or a natural disaster such as an earthquake.

 

This condition causes similar symptoms as a heart attack but is different from one because there is evidence on an angiogram of blockages in the coronary arteries. However, patients can have typical EKG changes of a heart attack as well as a rise in cardiac biomarkers (substances released into the blood when the heart is damaged). This makes it difficult to distinguish from a heart attack until an angiogram is performed.

 

The syndrome was first described in 1990 in Japan and has since been increasingly recognized around the world. It is much more common in women than men and occurs predominantly in older adults. The term “takotsubo” is taken from the Japanese name for an octopus trap used by fisherman, which has a shape that is similar to that of a heart affected by TTS.

 

Most of the abnormalities in heart function clear up in one to four weeks, and most patients recover fully within two months. However, this latest study indicates that alignancy rates were significantly higher among TTS patients than among similar patients with acute coronary syndrome – or a typical heart attack – (18% vs. 11%). The most common malignancies in TTS patients were breast and gastrointestinal cancers.

 

The authors point out: “History of malignancy might increase the risk for TTS, and therefore, appropriate screening for malignancy should be considered in these patients.”